Provider Demographics
NPI:1053395533
Name:TWYMAN, MICHAEL ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLEN
Last Name:TWYMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1034 S BRENTWOOD BLVD STE 1230
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1221
Mailing Address - Country:US
Mailing Address - Phone:314-635-9028
Mailing Address - Fax:314-293-6738
Practice Address - Street 1:1034 S BRENTWOOD BLVD STE 1230
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1221
Practice Address - Country:US
Practice Address - Phone:314-635-9028
Practice Address - Fax:314-293-6738
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012009166207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease